Health Benefits Exchange Not Paying Premiums

If you bought coverage through the Washington Health Benefits Exchange, you may want to check and make sure that your premiums are being paid to your insurance company.

It has been brought to our attention that it’s quite possible that the HBE may be taking your premiums and not forwarding those on to the insurance company. Unfortunately if you don’t know to check before hand, you may find out when you are denied coverage. That is what happened to one of our listeners.

Tina has been paying her premiums each month and has the receipts from the state to prove that, but when she tried to fill her prescription, she was told she did not have coverage. That’s when she contacted Premera and found out that the last payment they had received from the HBE was for February…she had paid through May.

Okanogan Country Radio attempted to contact the Health Benefit’s Exchange. A phone message was not returned, however spokesperson Bethany Frey did respond to our email asking for the customer’s name so they could investigate. Frey said, “ I don’t have a number of how many people have been affected by a payment issue specifically.” She said, “We have been making numerous improvements to our data transfer process between our system and the insurance carriers, including more than 100 data fixes and manual fixes.” She said, “These fixes address issues that would affect customers with any insurance company.”

This isn’t the only person this is happening to. Kara Klotz, with the Washington Insurance Commissioner’s office says her agency is working with the Governor’s office to try to get this issue resolved.

Klotz said they have been hearing from residents across the state with the same problem. Klotz is advising residents to check on their premium status with their insurance company and if they have not been paid, to contact the Insurance Commissioner’s toll free number at 1-800-562-6900.

Klotz said she could not say for sure how many people this is affecting because they only have numbers for the people who have contacted them to complain. She said they have heard from individuals who are being denied care because of the issue. She said if that happens that customers should call their toll free number and their consumer advocates can help to get their issue resolved. And again that number is 1-800-562-6900.